Intravenous injection of dexamethasone is non-inferior to perineural administration for popliteal sciatic nerve and saphenous nerve blocks: A randomized, controlled, triple-blind study

The aim of this study was to assess whether intravenous dexamethasone was noninferior to perineural dexamethasone as an adjuvant to ropivacaine for a combination of saphenous and sciatic nerve blocks in patients undergoing foot and ankle surgery. This was a prospective, blinded, randomized noninferi...

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Published in:Heliyon 2024-04, Vol.10 (7), p.e28304-e28304, Article e28304
Main Authors: Lei, Guiyu, Yang, Siliu, Wu, Lili, Yin, Yue, Zhang, Shu, Wang, Guyan
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Language:English
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Dexamethasone
Foot and ankle surgery
Intravenous
Nerve block
Perineural
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description The aim of this study was to assess whether intravenous dexamethasone was noninferior to perineural dexamethasone as an adjuvant to ropivacaine for a combination of saphenous and sciatic nerve blocks in patients undergoing foot and ankle surgery. This was a prospective, blinded, randomized noninferiority study. Seventy-five patients, aged 18–75 years, with an American Society of Anesthesiologists (ASA) physical status I-III who underwent foot and ankle surgery were involved. Patients scheduled for ultrasound-guided popliteal sciatic nerve block and saphenous nerve block were randomized to receive 0.375% ropivacaine with 7.5 mg of dexamethasone perineurally (Dex-PN), 10 mg of dexamethasone intravenously (Dex-IV) or neither (Placebo). The primary outcome was the duration of analgesia. The major secondary outcomes were the composite pain intensity and opioid consumption score at 0–48 h intervals after anesthesia. The mean analgesic duration was 26.2 h in the Dex-IV group and 27.9 h in the Dex-PN group (duration difference, −1.7; 95% CI, −3.8 to 0.43; P = 0.117), and both durations were significantly longer than that in the placebo group (17.6 h, P 
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Our findings indicate that a single 10-mg intravenous dose of dexamethasone was noninferior to the combined dose of ropivacaine plus deaxmethasone in terms of duration of analgesia for foot and ankle surgery. •Question: Whether IV dexmethasone is non-inferior compared to its perineural counterpart in extending PNB duration ?•Findings: IV dexamethasone was non-inferior to the perineural route with respect to the prolonged analgesia duration.•Meaning: IV dexamethasone at a dose of 10 mg is clinically recommended as a local anesthetic adjunct.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>38571656</pmid><doi>10.1016/j.heliyon.2024.e28304</doi><orcidid>https://orcid.org/0000-0003-3098-5472</orcidid><oa>free_for_read</oa></addata></record>
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subjects Dexamethasone
Foot and ankle surgery
Intravenous
Nerve block
Perineural
title Intravenous injection of dexamethasone is non-inferior to perineural administration for popliteal sciatic nerve and saphenous nerve blocks: A randomized, controlled, triple-blind study
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